HEALTH OF WOMAN. 2020.5-6(151-152): 66-70; doi 10.15574/HW.2020.151-152.66
Romanenko T. G.¹, Ignatiuk T. N.², Molthanova E. A.^3
1Shupyk National Medical Academy of Postgraduate Education, Kiev
²MC LLC “ISIDA-IVF”, Kyiv
³Nadiya Reproductive Medicine Clinic, Kyiv

The objective: to study the effectiveness and safety of modern antiandrogen therapy in patients with polycystic ovary syndrome (PCOS).
Materials and methods. Materials and methods. The first (main) study group included 39 patients with PCOS who received combination nonsteroidal antiandrogen therapy: antiandrogen drug containing flutamide (125 mg 3 times a day) and phyto drug Ovarimedin 1 capsule 2 times a day after meals for 6 months . The II (control) group included 37 patients who received a combination drug containing 35 μg of ethinylestradiol and 2 mg of cyproterone acetate for 6 months.
Results. After the course of treatment, biphasic MC was preserved in 25 (64.1%) patients of group I, and in 14 (37.8%) of group II. In group I, before the treatment of stage III hirsutism was in 23 patients (58.9%), after treatment – in 6 patients (15.3%); II stage in 10 patients (25.6%) before treatment, after treatment – in 18 patients (46.1%); I stage was found in 6 patients before treatment (15.5%) and in 15 patients (38.6%) after treatment. In group II patients, stage ІІІ hirsutism was detected in 21 patients (56.7%) before treatment, and in 7 patients (18.9%) after treatment; II stage in 9 patients (24.3%) before treatment, after treatment – in 13 patients (35.1%); I stage was found in 7 patients before treatment (19.0%) and in 17 patients (45.9%) after treatment.
Conclusions. Antiandrogenic nonsteroidal therapy with multicomponent herbal drug (Ovaremidine) and nonsteroidal antiandrogens may be recommended for the treatment of women with functional hyperandrogenism accompanied by hirsut syndrome, menstrual irregularities and / or infertility.
Our study confirmed that the use of this therapy contributes to the effective treatment of hirsutism, the restoration of menstrual disorders and fertility in women.
Differential algorithm for the treatment of hyperandrogenism of various etiologies, which can be recommended in the clinical practice of obstetricians and gynecologists.
Keywords: hyperandrogenism, polycystic ovary syndrome (PCOS), menstrual cycle, infertility, hirsutism, phytotherapy.

REFERENCES

1. Kamins’kyj VV, Tatarchuk TF, Dubossarska YuO. 2016. National consensus on the management of patients with hyperandrogenism. Reproductive Endocrinology. 4(30):19-31. https://doi.org/10.18370/2309-4117.2016.30.19-31.

2. Semenyuk LM. 2013. Giperandrogeniya yak chinnik reproduktivnih vtrat. Klinichna endokrinologiya ta endokrinna hirurgiya 1(42):71–80.

3. Zaporozhan VM, Boris OM, Reznikov OG, Nosenko ND. 2012. Hronicheskaya giperandrogennaya anovulyatsiya: nead’yuvantnaya antiandrogennaya terapiya i provedenie tsiklov vspomogatelnyih reproduktivnyih tehnologiy s uchetom testirovaniya na polimorfizm genov FSHR i ESR2 (monografiya). K:138.

4. Manuhin IB, Tumilovich LG, Gevorkyan MA. 2013. Ginekologicheskaya endokrinologiya. Klinicheskie lektsii: rukovodstvo dlya vrachey. 3-e izd., pererab. M, GEOTAR_MEDIA:272.

5. Murashko NV, Danilova LI. 2010. Sindrom giperandrogenii u zhenschin reproduktivnogo vozrasta: klinika, differentsialnyiy diagnoz. Uchebno-metodicheskoe posobie. Minsk:33.

6. Pedachenko NYu. 2014, sentyabr. Menstrualna disfunktsiya u zhinok z metabolichnym sindromom. Reproduktivnaya endokrinologiya 4(18):106-114.

7. Ojeda-Ojeda M, Murri M, Insenser M, Escobar-Morreale HF. 2013. Mediators of low-grade chronic inflammation in polycystic ovary syndrome (PCOS). Curr. Pharm. Des. 19;32:5775-5791.
https://doi.org/10.2174/1381612811319320012; PMid:23448487

8. Weiss RV, Clapauch R. 2014. Female infertility of endocrine origin. Arq. Bras. Endocrinol. Metabol. 58;2:144-452. https://doi.org/10.1590/0004-2730000003021; PMid:24830591

9. Ryikova OV. 2014. Sindrom polikistoznyih yaichnikov – diagnoz isklyucheniya i mezhdistsiplinarnaya problema. Zdorov'ya Ukrainy. 7:60-64.

10. Goodarzi MO, Carmina E, Azziz R. 2015. DHEA, DHEAS and PCOS. J. Steroid. Biochem. Mol. Biol. 145:213-25. https://doi.org/10.1016/j.jsbmb.2014.06.003; PMid:25008465

11. Milewicz A, editor. Endokrynologia kliniczna. Wroclaw:Polskie Towarzystwo Endokrynologiczne: 1224. 2012.

12. Dubossarska ZM, Dubossarska YuA, Duka IuM, Nagorniuk VT, authors; Dubossarskaia ZM, editor. Teoriia i praktika endokrinnoi ginekologii. Theory and practice of endocrine gynecology. Dnipropetrovsk, Lira: 459. 2010.

13. Bachelot A. 2016, Dec 1. Polycystic ovarian syndrome: clinical and biological diagnosis. Ann Biol Clin. Paris. 74(6):661-667. https://doi.org/10.1684/abc.2016.1184; PMid:27848917

14. Urbanovych AM. 2013. Hormones of adipose tissue and theirclinical significance. Endokrynologia 18(1):69-72.

15. Tatarchuk TF, Voronenko NYu, Kapshuk IM. 2013. State of adipose tissue at polycystic ovary syndrome. Health of woman 10:35-38. (

16. Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Consensus on women's health aspects of polycystic ovary syndrome (PCOS). Hum Reprod. 27(1):14-24. 2012, Jan. https://doi.org/10.1093/humrep/der396; PMid:22147920

17. Сonway G, Dewailly D, Diamanti-Kandarakis E et al. 2014, Oct. The polycystic ovary syndrome: a position statement from the European Society of Endocrinology. Eur J Endocrinol. 171(4):P1-29. https://doi.org/10.1530/EJE-14-0253; PMid:24849517

18. Department of Reproductive Health, World Health Organization. Medical eligibility criteria for contraceptive use. 5th ed. Geneva, WHO Press: 269. 2015.

19. Tatarchuk TF, Ganzhiy IYu, Pedachenko NYu, Kapshuk IM. 2013, noyabr. Suchasni mozhlivosti negormonalnogo likuvannya sindromu polikistoznih yaechnikiv u zhinok z ozhirinnyam. Reproduktivnaya endokrinologiya 5(13):14-21.